Anaemia worries in week 35...really low count !!

[CrazyDi]

Had a midwife appointment today and it went well apart from my dreaded anaemia...again!! she is concerned because my count hasnt gone above 8.5 and she suspects its got worse.

My concern is that she says that when she gets the results (which she is rushing) if they are as bad/worse then she will refer me to the hospital for treatment...Anyone have any experience with this? I am constantly being sick so cant take meds at home, so will they want me to go in?? And if so for what????

Sorry to sound so naive, just worried as have 2 kiddies already at home and a hubby that worries like crazy!!

Hey CrazyDi,

That is low. Did your mw not tell you what the possible treatment would be? I am slightly anaemic but it is not that low although it seems to be getting worse. I am 36 weeks pg. They said they might put me on iron tablets if it gets too bad.

Sorry I don't know but Mears might pop in later...

Ideal level is between 9 and 9.5 in late pregnancy. Haemoglobin concentration is ideal at that, it means the placenta is working well at diluting your blood.

8.5 sounds quite low at 35 indeed.

This is the most authoritative study on this issue. 100g/l is the same as 10.0 g/dl .

BMJ 1995 Feb 25;310(6978):489-91

Relation between maternal haemoglobin concentration and birth weight in different ethnic groups.

Steer P, Alam MA, Wadsworth J, Welch A.

Academic Department of Obstetrics and Gynaecology, Charing Cross and Westminster Medical School, Chelsea and Westminster Hospital, London.

OBJECTIVETo assess the relation of the lowest haemoglobin concentration in pregnancy with birth weight and the rates of low birth weight and preterm delivery in different ethnic groups. DESIGNRetrospective analysis of 153,602 pregnancies with ethnic group and birth weight recorded on a regional pregnancy database during 1988-91. The haemoglobin measurement used was the lowest recorded during pregnancy. SETTINGNorth West Thames region. SUBJECTS115,262 white women, 22,206 Indo-Pakistanis, 4570 Afro-Caribbeans, 2642 mediterraneans, 3905 black Africans, 2351 orientals, and 2666 others. MAIN OUTCOME MEASURESBirth weight and rates of low birth weight (< 2500 g) and preterm delivery (< 37 completed weeks). RESULTSMaximum mean birth weight in white women was achieved with a lowest haemoglobin concentration in pregnancy of 85-95 g/l; the lowest incidence of low birth weight and preterm labour occurred with a lowest haemoglobin of 95-105 g/l. A similar pattern occurred in all ethnic groups. CONCLUSIONS--The magnitude of the fall in haemoglobin concentration in pregnancy is related to birth weight; failure of the haemoglobin concentration to fall below 105 g/l indicates an increased risk of low birth weight and preterm delivery. This phenomenon is seen in all ethnic groups. Some ethnic groups have higher rates of low birth weight and preterm delivery than white women, and they also have higher rates of low haemoglobin concentrations. This increased rate of "anaemia," however, does not account for their higher rates of low birth weight, which occurs at all haemoglobin concentrations.

My midwife just said refer me to the hospital for treatment..I had a miscarriage last year and had to have a transfusion because of anaemia and had a drip once before...these wouldnt be possible in pregnancy though would they...so I am stumped!!

You could give the BMJ study below to your MW as it actually says 8.5 is fine...

I think that although it is important to hear what the MWs have to say, it is also important to know that they don't know it all and they do get things wrong sometimes.

Therefore we need to look at other sources for information and try and keep a cool head gal. I know it is not easy but try. I always question what they tell me.

CrazyDi - 8.5 is pretty low. Your midwife will have taken blood to test whether this is true iron deficiency anaemia or not. If so, it is important to give you a treatment you can tolerate. It could be iron syrup, iron injections or, if it does drop more, possibly a blood transfusion. There are lots of different iron preparations and it just may be that you haven't found the right one yet.

My doctors surgery have just rang me now...they took the blood yesterday morning and have results back already!! They want me to go see dr so god only knows now!!

funny how i have had a crippling uti infection for 4 weeks now and they keep repeating the msu test yet bloods can be done in less than 24 hours!! aarrgghh!!

Hopefully DR will help get the anaemia sorted out which in turn will help UTI. The 2 things go hand in hand I am afraid. Hope you feel better soon.